Acute prostatitis is an inflammation of the prostate gland that develops suddenly.

Acute prostatitis is usually caused by a bacterial infection of the prostate gland. Any organism capable of causing an urinary tract infection (UTI) is also capable of causing acute bacterial prostatitis, including enterococci, Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus aureus.

Some sexually transmitted diseases (STDs) can cause acute prostatitis, typically seen in men younger than 35. These include gonorrhea, chlamydia, urealyticum, and trichomonas. Prostatitis from an STD typically closely follows sexual contact with an infected partner.

In men older than 35, E. coli and other common bacteria are more often the cause of prostatitis. E. coli prostatitis may follow urinary tract infections, urethritis, or epididymitis.

Acute prostatitis may also develop as a result of procedures involving the urethra, such as:

• Catheterization or cystoscope
• Trauma
• Bladder outlet obstruction
• An infection elsewhere in the body. Prostatitis is rare in young boys.

Prostatitis is diagnosed in approximately 2 of every 10,000 outpatient visits. Men between the ages of 20 and 35 who have multiple sexual partners are at an increased risk. Also at high risk are those who engage in anal intercourse, especially without using condoms.

Men age 50 or older who have an enlarged prostate (benign prostatic hyperplasia), are at increased risk for prostatitis due to their risk of urinary tract infection.

Acute prostatitis often begins with chills and fever, lower abdominal discomfort, perineal pain (pain in the area between the genitals and the anus), and burning with urination. Symptoms of more advanced prostatitis include a diminished urine stream and difficulty urinating.

Prostatitis may occur in conjunction with epididymitis or orchitis, especially if caused by an STD, in which case symptoms of the accompanying condition may also be present.

Symptoms of acute prostatitis include the following:

• Fever
• Chills
• Low back pain
• Abdominal pain (above the pubic bone)
• Perineal pain (pelvic floor)
• Pain and burning with urination (dysuria)
• Urinary retention (inability to completely empty bladder)
• Pain with ejaculation
• Pain with bowel movement

• Blood in the urine
• Increased urinary frequency or urgency
• Difficulty urinating
• Decreased force of urinary stream
• Testicle pain
• Blood in the semen
• Foul-smelling urine

Your health care provider may perform a physical examination to assess the prostate (warm, soft, swollen, or tender), the groin lymph nodes (enlarged or tender), the scrotum (swollen or tender), and the urethra (discharge).

Triple-void urine specimens may be collected for urinalysis and urine culture:

• #1 initial stream
• #2 mid-stream
• #3 after prostatic massage by examiner

Note: Your health care provider may choose not to perform prostatic massage if the prostate is obviously swollen and tender, because massage may potentially spread the infection and cause bacteremia or sepsis. These are potentially life-threatening infections in which bacteria are present in the bloodstream, rather than localized to one part of the body.

Urinalysis may reveal increased white blood cells (WBCs) and bacterial growth. Examination of prostatic secretions may also show increased levels of WBCs and concentrated bacterial growth upon culture.

Acute prostatitis may also alter the results of the following tests:

• CBC
• Urine analysis
• PSA
• Semen analysis